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<html>
<head>
    <meta http-equiv="Content-Type" content="text/html; charset=utf-8"/>
    <meta name="viewport" content="initial-scale=1.0, user-scalable=no, width=device-width">
    <title>滴滴打人问卷调查</title>
    <link href="bootstrap/css/bootstrap.min.css" rel="stylesheet">
    <script src="bootstrap/jquery/jquery-2.1.3.min.js"></script>
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    <script type="text/javascript">
        $(function () {
            $("#submit").click(function () {
                $.get("/saveCoupon", {couponId:3}, function (date) {})
                window.location.href="http://xiaozhuzi.imwork.net/index"
            })
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</head>
<body class="col-xs-12">
<br/><br/>

<h1 class="form-group col-xs-12" align="center"><font color="#FF0000">
    滴滴打人问卷调查
</font></h1>
<h4 class="form-group col-xs-12" align="center">
    完成调查即可获得本公司<a><font color="#a52a2a">服务体验卷</font></a>一张
</h4>

<form class="navbar-form navbar-default ">
    <div class="form-group col-xs-12">
        <label>姓名 :</label>
        <input class="form-control">
    </div>
    <div class="form-group col-xs-12">
        <label class="">性别 :</label>
        <div class="radio ">
            <label>
                <input class="radio" type="radio" name="optionsSex" checked>
                男
            </label>
            <label>
                <input class="radio" type="radio" name="optionsSex">
                女
            </label>
        </div>
    </div>

    <div class="form-group col-xs-12">
        <label>年龄 :</label>
        <input class="form-control" placeholder="岁">
    </div>
    <div class="form-group col-xs-12">
        <label>体重 :</label>
        <input class="form-control" placeholder="公斤">
    </div>

    <div class="form-group col-xs-12">
    <label >何种途径知道本公司 :</label>
        <div class="radio ">
            <label >
                <input class="radio" type="radio" name="optionsRadios" id="optionsRadios1" checked>
                从我们雇主处听到过
            </label>
        </div>

        <div class="radio">
            <label >
                <input class="radio" type="radio" name="optionsRadios" id="optionsRadios2">
                曾被我们的员工打过
            </label>
        </div>

        <div class="radio ">
            <label >
                <input class="radio" type="radio" name="optionsRadios" id="optionsRadios3">
                街边派小广告看到过
            </label>
        </div>
    </div>
    <div class="form-group col-xs-12">
        <label class="">你觉得本网站 :</label>
        <div class="radio">
            <label >
                <input class="radio" type="radio" name="options" checked>
                非常好
            </label>
        </div>
        <div class="radio">
            <label >
                <input class="radio" type="radio" name="options" >
                很好
            </label>
        </div>
        <div class="radio">
            <label >
                <input class="radio" type="radio" name="options" >
                好
            </label>
        </div>
    </div>

    <div class="col-xs-12">
        <label>对本站有何建议 :</label>
        <textarea class="form-control" rows="3"></textarea>
    </div>
    <div class="col-xs-12">
        <label>联系方式 :</label>
        <input class="form-control" placeholder="手机或邮箱都可以~">
    </div>
    <button type="button" data-toggle="modal" class="btn btn-success col-xs-12 " data-target="#myModal">提交</button>
</form>

<div class="col-xs-12">
    <p align="center">活动最终解释权由本公司<font color="#a52a2a">滴滴打人</font>所有</p>
</div>

<div class="modal fade" id="myModal" tabindex="-1" role="dialog" aria-labelledby="myModalLabel">
    <div class="modal-dialog" role="document">
        <div class="modal-content">
            <div class="modal-header">
                <button type="button" class="close" data-dismiss="modal" aria-label="Close"><span aria-hidden="true">&times;</span></button>
                <h4 class="modal-title" id="myModalLabel">提交成功！</h4>
            </div>
            <div class="modal-body">
                恭喜获得一次免费服务体验！
            </div>
            <div class="modal-footer">
                <button type="button" class="btn btn-warning" data-dismiss="modal">不打，滚</button>
                <button type="button" class="btn btn-primary" id="submit">马上去打人</button>
            </div>
        </div>
    </div>
</div>
</body>
</html>

